Retinal Hemorrhages: Etiologies, Diagnostic Approaches, and Management Strategies for Ocular and Systemic Disorders
Amer Hassan Mohammed Al-Shahri 1*, Ali Mesfer Alkhathami 1, Ali Jamal Faleh Al-Anzi 1, Binselm, Khalid Rashad A 1, Faleh Mohammed Al Dawsar 1, Al Duheem, Bader Sughayir D 1, Ahmad Ayad M Avaz 1, Naif Munif Aldumayki Alotaibi 1, Saleh Helayyil Saleh Alharbi 1, Rayan Mohammed Mubarak Alotaibi 1
Journal of Angiotherapy 8(8) 1-8 https://doi.org/10.25163/angiotherapy.8810216
Submitted: 30 May 2024 Revised: 12 August 2024 Published: 15 August 2024
Abstract
Retinal hemorrhages are pivotal clinical findings that signify a broad range of ocular and systemic pathologies, varying from benign to vision-threatening conditions. This review highlights the etiologies, clinical implications, diagnostic challenges, and emergency management strategies associated with retinal hemorrhages. A systematic analysis of peer-reviewed literature, clinical guidelines, and recent studies was performed, focusing on hemorrhage classification, pathophysiology, diagnostic approaches, and treatment protocols. Findings reveal that hemorrhage location critically influences prognosis and treatment strategies, with systemic diseases such as hypertension, diabetes, and coagulopathies accounting for 70% of adult cases. Nd:YAG laser membranotomy achieves up to 85% visual recovery in subhyaloid hemorrhages, while timely intervention within 7–14 days is crucial for submacular hemorrhages to prevent photoreceptor damage. Multidisciplinary management enhances outcomes in trauma- and abuse-related hemorrhages. Diagnostic imaging modalities like optical coherence tomography (OCT) and fundus fluorescein angiography (FFA), combined with targeted laboratory tests, are essential for accurate diagnosis. Ultimately, tailored management strategies based on anatomical and systemic contexts, coupled with prompt intervention, are critical for preserving vision and addressing underlying systemic disorders.
Keywords: retinal hemorrhage, submacular hemorrhage, vitreous hemorrhage, Terson syndrome, hypertensive retinopathy
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